Altering plasma sodium concentration rapidly changes blood pressure during haemodialysis

作者: R. J. Suckling , P. A. Swift , F. J. He , N. D. Markandu , G. A. MacGregor

DOI: 10.1093/NDT/GFT081

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摘要: BACKGROUND Plasma sodium is increased following each meal containing salt. There an increasing interest in the effects of plasma concentration, and it has been suggested that may have direct on blood pressure (BP) possibly influences endothelial function. Experimental increases concentration rapidly raise BP even when extracellular volume falls. METHODS Ten patients with end-stage renal failure established haemodialysis were studied during first 2 h dialysis without fluid removal this period. They randomized to receive (i) dialysate prescribed 135 mmol/L (ii) 145 random order a prospective, single-blinded crossover study. measurements samples taken every 30 min. RESULTS Pre-dialysis sitting was 137/76 ± 7/3 mmHg. Lower (135 mmol/L) reduced [139.49 0.67 135.94 0.52 (P < 0.001)], whereas not altered by higher (145 (140.17 0.66 at baseline 140.72 0.43 120 min). Systolic lower [area under curve (AUC) 15823.50 777.15 (mmHg)min] compared [AUC 17018.20 1102.17 (mmHg)min], mean difference 1194.70 488.41 (mmHg)min, P 0.05. significant positive relationship between change systolic BP. This suggests fall 1 would be associated 1.7 mmHg reduction 0.05). CONCLUSIONS The potential mechanism for increase seen salt intake through small but changes concentration.

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